背景:冠状推进皮瓣(CAF)可以是治疗牙龈凹陷的可预测的手术技术。然而,缺陷的特征(例如,有限量的角化牙龈或皮瓣张力,等。)可能会限制CAF的使用,可能需要额外的手术干预(即,使用从供体部位或结缔组织替代品收获的组织移植物)。
方法:一名28岁女性患者,无牙周病史,来转诊,将牙龈萎缩作为主要投诉,不良的美学,和牙齿11、12和13的颊表面的牙本质过敏。临床上,她表现出牙龈衰退型的厚表型,RT1,在第二象限中具有可检测的牙骨质-牙釉质交界处(A-)。为了减少采集软组织移植物的需要,从皮瓣内部切断肌肉和血管的量,并减轻与CAF相关的术后不适,本文描述了一种新颖的手术方法,该方法使用先进的皮瓣,该皮瓣沿粘膜牙龈交界处合并了一个外部切口。
结果:本病例报告中提出的新方法实现的平均根覆盖率为95%,随着增加的角化牙龈和最小的术后患者的不适。
结论:粘膜释放CAF是一种有前途的技术,其中单独的CAF技术可能不是适应症。
结论:该技术具有以下优点:减少了采集软组织移植物的需要。减少从皮瓣内部切割肌肉和血管的量。患者术后最小不适。
BACKGROUND: The coronally advanced flap (CAF) can be a predictable surgical technique for the treatment of gingival recessions. However, the characteristics of the defect (e.g., limited amount of keratinized gingiva or flap tension, etc.) may limit the use of the CAF with a possible requirement of additional surgical interventions (i.e., the use of a tissue graft to be harvested from donor sites or connective tissue substitutes).
METHODS: A 28-year-old woman patient, with no history of periodontal disease, came for referral presenting receding gums as a chief complaint, poor esthetics, and dentinal hypersensitivity at the buccal surface of teeth 11, 12, and 13. Clinically, she presented a thick phenotype with gingival recession type, RT1, with detectable cemento-enamel junction (A‒) in the second quadrant. To reduce the need of harvesting soft tissue grafts, the amount of cutting of muscles and vessels from the inner portion of the flap and mitigate the postoperative discomfort associated with the CAF, a novel surgical approach is described here using an advanced flap that incorporates an external incision along the mucogingival junction.
RESULTS: The average root coverage achieved with the novel procedure presented in this
case report was 95%, along with an increased amount of keratinized gingiva and minimal postoperative patient\'s discomfort.
CONCLUSIONS: The mucosal released CAF is a promising technique in which the CAF technique alone may not be an indication.
CONCLUSIONS: This technique has the following advantages: Reduce the need of harvesting soft tissue grafts. Reduce the amount of cutting of muscles and vessels from the inner portion of the flap. Minimal postoperative discomfort for the patient.